Sections of dermatologists have objected to an India-specific name that has stuck to a fungus that causes widespread and hard-to-treat skin infections and is resistant to most anti-fungal medicines, saying the name is “inaccurate and pejorative”.

The fungal species, named Trichophyton indotineae, has turned up in over 40 countries and its origin currently remains unknown, a 35-member group of dermatologists from India and 13 other countries has said, calling for a nomenclature
revision.

Vadodara-based dermatologist Shyam Verma and his colleagues in India and Germany were among the first to identify the new fungus in patients in India and other South Asian countries more than five years ago.

It has since then turned up elsewhere in Asia, Europe and North America.

Bangladesh, Nepal, Sri Lanka, Iran, Iraq and the UAE have documented outbreaks of this chronic and treatment-resistant infection, which has forced doctors to resort to a final-resort antifungal agent, called itraconazole.

Japanese dermatologists who had spotted the fungus in one patient each from India and Nepal had proposed in 2020 that it should be considered a new species and
named Trichophyton indotineae, in line with a historical tradition of linking new infectious agents to specific locations.

But a location-specific name might reinforce stigma and prejudice and disregard exhortations by the World Health Organisation and the American Society of Microbiology, the 35-member dermatology group has said in the Indian Journal of Dermatology, Venereology and Leprology.

“Naming the fungus after India is unjustified and incorrect,” Kabir Sardana, professor and head of dermatology at the Ram Manohar Lohia Hospital in New Delhi and a co-author, told The Telegraph. “It could also distract the medical community from an urgent need to understand why this fungus has become so resistant.”

Indian and German dermatologists were among the first to flag concerns about the emergence of the drug-resistant fungus by 2019. But researchers say the evidence suggests that the fungus existed in several other countries before 2019.

Verma and other dermatologists had suggested in the past that indiscriminate sale and use of irrational cocktails of skin creams containing steroids and anti-fungal agents in India had contributed to the spread of the drug-resistant fungi. But the connection needs to be probed with greater scientific rigour.

“The fungus has been detected in 42 countries and it is by no means certain that the primary infection in every country originated in India,” said Verma, another co-author in the call for a name change.

The dermatologists have called for the establishment of an international committee or a body to assess contentious names. “Until then, such pejorative terms should be discouraged and more neutral terms should be used,” they have written.

Naming diseases after places was a habit in an era when the actual causes of new diseases were not known and the places served as an easy way to identify them, said Abir Saraswat, a dermatologist in Lucknow and another co-author.

“Now, with a deeply interconnected world, it can be very hard to pinpoint exactly where a disease or organism first emerged,” Saraswat said. “And naming them after a place serves no useful purpose when accurate, scientific and descriptive ways of naming microbes are available.”

Kaushal Verma, head of dermatology and dean at the All India Institute of Medical Sciences, New Delhi, and another co-author, said: “When we have molecular tools to identify and classify microbes, it is inappropriate to name them after geographical locations.”

Doctors too have asserted that the identification of the problem in India does not necessarily mean that it originated in India. “Only when you make efforts to look for something with the appropriate tools will you find it,” said Verma, dean at the AIIMS.